Why We're Losing the War Against HIV/AIDS

Do sexual abstinence and marital fidelity help in the global fight to prevent the spread of HIV? Public health expert Edward C. Green, a senior research scientist at Harvard University and author of Rethinking AIDS Prevention, has studied the spread of HIV and AIDS in southern African since the late 1980s. His analysis of the now-famous A-B-C strategy (abstain, be faithful, or use a condom) suggests a strong, causal link between this prevention strategy and the major reduction of HIV cases in Uganda.

But new research from Columbia University researchers found no evidence that abstinence and fidelity caused the overall decline of HIV in Uganda between 1994 and 2002. The study reported that increased use of condoms and the death of AIDS patients resulted in fewer HIV cases. Green rejected those new findings during an interview with Tim Morgan, Christianity Today's deputy managing editor. (An edited transcript.)

What's your reaction to new field research casting doubt on the role of abstinence and fidelity in lowering HIV in Uganda?

Every two or three years, somebody does a study comparing behavior in Uganda between the mid-1990s and now. And it's the same old stuff. Most behavioral change in Uganda was in the latter 1980s and early 1990s.

So benefits to public health from fewer people with HIV in that earlier period carried beyond the mid-1990s?

The first thing that happens is the rate of new infections goes down quickly when you're changing your behavior. And that's called the incidence rate. So the incidence rate started going down in the later 1980s and early 1990s and then it's the dynamics of epidemics that even if you don't really do anything after that, prevalence continues to go down for a number of years after the major ...

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